The treatment, procedure, specialist consultation or diagnostic tests that you are claiming for under your AIA Private Health policy. A health anomaly or defect which is present at birth and for which the life assured either had signs or symptoms prior to becoming a life assured , or signs or symptoms within 3 months of birth. A continuous period of cover from the risk commencement date during which the premium is paid for the life assured . A recognised health professional, who is registered with the Dental Council of New Zealand (or its successor). The excess is the amount that you will be responsible to pay for any treatment or procedure before you are entitled to claim for, or be reimbursed for, any benefits that are payable under this policy. A recognised health professional, who holds a current annual practising certificate and is a member of the Medical Council of New Zealand (or its successor). A Government agency, department or organisation including without limitation, ACC and Work and Income New Zealand (or its successor).
claim event
congenital condition
continuous cover
dental practitioner
excess
general practitioner
Government authority
The person or people insured for the benefit(s) as named in the schedule .
life/lives assured
A statement is material only if that statement would have influenced the judgment of a prudent insurer in fixing the premium or in determining whether he/she would have taken or continued the risk upon the same terms. The maximum amount AIA will pay for each benefit or combination of benefits, as specified for the benefit(s). A service or supply provided by a registered medical practitioner or specialist that AIA deems on reasonable grounds is necessary for the diagnosis, care or treatment of the disease or illness involved. Under no circumstances will the following services or supplies be considered medically necessary: > those services or supplies that do not require the skills or services of a registered medical practitioner or specialist ; > those services or supplies furnished mainly for the comfort or convenience of the life assured . > those services or supplies that do not relate to the medical treatment being provided (for example alcohol, toiletries, pay TV, car parking and take away meals).
material
maximum cover
medically necessary
occupational therapy Treatment provided by a registered occupational therapist who is:
> in private practice and holds a current annual practicing certificate; and
> a member of the Occupational Therapy Board of New Zealand (or its successor).
An oral surgeon, oral medicine specialist or oral and maxillofacial surgeon registered with the Dental Council of New Zealand (or its successor) or a specialist vocationally registered in OralMaxillofacial surgery.
oral surgeon
The date that the relevant change to AIA’s Private Health policy comes into effect, as determined by AIA .
pass back date
1300 APH-UMB version 6 Effective 17 April 2025
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